New England Surgical Society

NewsletterFROM THE PRESIDENT

August 2008Volume 10, Number 2

(continued on page 6)

Editor’s Corner Bruce J. Leavitt, MD

(continued on page 7)

2007-2008 Executive Committee

PresidentThomas A. Colacchio, MD

President-ElectFrancis D. Moore, Jr., MD

Vice PresidentJack M. Monchik, MD

SecretaryThomas F. Tracy, Jr., MD

TreasurerNicholas P.W. Coe, MD

RecorderNeil S. Yeston, MD

Past PresidentJohn P. Welch, MD

Representative to theACS Board of GovernorsCharles M. Ferguson, MD

Representative to ACS AdvisoryCouncil for General Surgery

Kristen A. Zarfos, MD

Representative toAmerican Board of SurgeryLenworth M. Jacobs, Jr., MD

Representative - ConnecticutKenneth A. Ciardiello MD

Representative - MaineFrederick R. Radke, MD

Representative - MassachusettsMichael D. Stone, MD

Representative - New HampshireA. Ronald Grimm, MD

Representative - Rhode IslandMichael P. Vezeridis, MD

Representative - VermontBruce J. Leavitt, MD

Office of the Executive Director900 Cummings Center, Suite 221-U

Beverly, Massachusetts 01915(978) 927-8330 / (978) 524-8890 fax

ness@prri.com

Thomas A. Colacchio, MD

It is mid August in New England. Windows at nightare open and a cool breeze helps us get good nightssleep. In fact, the weatherman tells me tonight in Ver-mont will have temperatures in the mid 40’s. That meansthat fall is in the air. With fall comes the annual meetingof the New England Surgical Society. This year ourmembers and guests will congregate in Boston, ourlargest city in New England. Us “country folk” from thenorthern reaches look forward to a trip to the “big city” fora little culture and excitement. This year’s program is exciting and will be wellworth attending. Dr. Walter Goldfarb will give a lecture on Harvey Cushingand the New England Surgical Society. Lucian Leape MD will give the 24th

Annual Mixter Lecture. Dr. Colacchio, our president, will give the Presidential

Thank you again for the privilege of being yourPresident this year. It certainly has been a busy one forthe Society and I am proud to report on some of theinitiatives that have been undertaken by our organiza-tion in 2008.

Richard Barth, 2008 Program Chair, has been hardat work with the other members of the Program Com-mittee on developing an excellent scientific program forour 89th Annual Meeting in Boston on September 26thto 28th. From the 66 abstracts that were submitted,Rick and his Committee selected 16 for PodiumPresentation, 12 as Brief Reports, and 35 for Poster

Presentation. The Basic and Clinical science winners from the Society’s Re-search Day this past May will also be presenting their work and the program willkick off with a special Historical paper on Friday afternoon.

Other highlights of the 2008 Annual Meeting include:• A Panel Discussion titled “When States Ensure Health Care Coverage:

Lessons from Maine, Massachusetts and Vermont” with guest panelists fromvarious organizations throughout New England

• Specialty Group Breakfast Sessions on Maintenance of Certification, AcuteCare Surgery, and On-Call Reimbursement

• A special dinner for Young Surgeons & New Members• A Satellite Symposium Highlighting Laparoscopic Liver Resection, Thyroidec-

tomy and Bariatric Surgery, conducted by Ethicon Endo-Surgery, on Satur-day afternoon

2

OBJECTIVEThe Annual Meeting is designed to provide one and

one half days of comprehensive educational experiencesin the fields of clinical surgery, experimental surgery andrelated sciences, surgical education and the socioeco-nomic aspects of surgical care. It is the Society’s intent tobring together at this meeting the leading surgeons andscientists from New England to freely and openly discusstheir latest clinical and research findings.

MEETING REGISTRATIONYou can register for the 89th Annual Meeting online, via

the NESS website. Visit www.NESurgical.org. This simpleand fast tool enables you to receive your confirmationimmediately. You may also choose to download and fax ormail the meeting registration form.

SEAPORT HOTELSeaport’s fresh and inviting surroundings reflect its

rejuvenating location on Boston’s historic waterfront.Stunning views, convenient location and gracious staff setthis Four- Diamond hotel apart. Once inside, Seaportdelights with unparalleled service, sophistication andinnovative amenities including a unique service-inclusivepolicy and technology that is always a step ahead.

89th Annual Meeting Highlights

24th Annual Samuel Jason Mixter LectureLucian Leape, MD, Boston, MA

Presidential AddressThomas A. Colacchio, MDDartmouth-Hitchock Medical Center

Panel Discussion: When States Ensure Health Care Coverage: Lessons from Maine, Massachusetts and Vermont

Moderator: Richard J. Barth, Jr., MDPanelists: Steven Michaud, Nancy Turnbull, PhD,

and James Hester, PhD

Welcome ReceptionThis year’s Welcome Reception will be held in the

new Lighthouse Ballroom of the Seaport Hotel. Enjoy theview and lights of Boston Harbor and downtown Bostonwith cocktails and hors d’oeuvres from 6:00 PM–7:00 PM.

Please note that only drinks and light appetizerswill be served and dinner arrangements should bemade in advance for that evening if you chose to doso.

PRELIMINARY PROGRAM (Subject to Change)

Friday, September 26, 2008

SCIENTIFIC SESSION I

PRE-CENTENNIAL HISTORY LECTURE: An Historical Paper:Harvey Cushing and the New England Surgical Society

Walter B. GoldfarbA Satisfying Surgical Practice: The Academic TraumaService Model

Suresh Agarwal, Lejla Hadzikadic, Peter A. Burke, AndrewGlantz, James Becker, Erwin Hirsch

Outcomes Following Thyroidectomy and Parathy-roidectomy in Pregnant Women in the US

SreyRam Kuy, Sanziana Roman, Leon Boudourakis, Julie AnnSosa

Outcome of Living Donor Liver Transplantation forHepatocellular Carcinoma

Khashayar Vakili, James Pomposelli, William D. Lewis, FredricD. Gordon, Maryann Simpson, Roger L Jenkins, Elizabeth A.Pomfret

Living Donor Kidney Transplantation with MultipleArteries: Recent Increase in Modern Era ofLaparoscopic Donor Nephrectomy

Reza Saidi, Tatsou Kawai, Peter Kennealey, George Tsouflas,Nahel Elias, Martin Hertl, A.B. Cosimi, Dicken S.C. Ko

Medical and Life Insurance Difficulties for Living OrganDonors

Jennifer E. Verbesey, Mary Ann Simpson, Elizabeth A. Pomfret

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Adrenal Biopsy is Unhelpful in the Evaluation of Adre-nal Incidentaloma : A Decade of Experience

Peter J. Mazzaglia, Jack M. MonchikOutcomes From 3,144 Adrenalectomies in the U.S.:Which Matters More, Surgeon Volume or Specialty?

Henry S. Park, Sanziana A. Roman, Leon Boudourakis, DanielC. Thomas, Julie Ann Sosa

Minimally Invasive Component Separation for Abdomi-nal Wall Reconstruction

Charles M. FergusonAbdominal Wall Reconstruction Using an AcellularPorcine Dermal Implant

Russell Babbitt, Genevieve B. Broderick, Nelson L. Jenkins,Timothy Emhoff, Janice F. Lalikos, Richard A. Perugini,Raymond M. Dunn

SCIENTIFIC SESSION II

Low Morbidity and Zero Mortality in an Initial Experi-ence of 500 Gastric Bypass Procedures

Jennifer E. Verbesey, Pam O’Brien, Corinne Vigilante, MaryAnn Simpson, Dmitry Nepomnayshy, David Brams

Pediatric Rib Fractures May Not be a Marker for WorseOutcomes

Amanda Feigel, Felix Y. Lui, Kevin M Schuster, Kimberly A.Davis

Indications and Outcomes for Video Assisted ThoracicSurgical Sympathectomy

Bruce J. LeavittExtracorporeal Membrane Oxygenation for Non-neona-tal Acute Respiratory Failure: The MassachusettsGeneral Hospital Experience from 1990 to 2008

Deepika Nehra, Allan M. Goldstein, Daniel P. Doody, Daniel P.Ryan, Peter T. Masiakos

Hemoglobin A1c as a Predictor for Coronary ArteryBypass Graft Surgery Complications

Krista E. Evans, Bruce J. Leavitt, Turner M. Osler, MitchellNorotsky

What is the Evidence for Anastomotic Leak Testing inColorectal Anastomoses

Rocco Ricciardi, Patricia L. Roberts, Peter W. Marcello, DavidJ. Schoetz, Lawrence C. Rusin

Fulminant Clostridium Difficile Colitis: Patterns of Careand Predictors of Mortality

Elizabeth A. Sailhamer, Katherine Carson, Yuchiao Chang,Nikolaos Zacharias, Konstantinos Spaniolas, Malek Tabbara,Hasan B. Alam, Marc A. DeMoya, George C. Velmahos

State Caucus Meetings

Saturday, September 27, 2008

SPECIALITY GROUP BREAKFAST

PROGRAM DIRECTORS BREAKFAST MEETING

INTRODUCTION OF NEW MEMBERS

SCIENTIFIC SESSION III

Increasing Rates of Colorectal Cancer Incidence andMortality Among Racial Minorities in Connecticut

Stanley K. Frencher, Jr., Walter E. Longo, Paul A. Sullivan,Charles Cha, Robert A Kozol,

Distal Margins in Radical Resections for Rectal Cancerafter Chemoradiation Therapy: How Short is LongEnough?

Victor E. Pricolo, Adam Abodeely, Mark Legolvan, MurrayResnick

National Patterns in the Management of IntraductalPapillary Mucinous Neoplasm: Are We Making a Differ-ence?

Jessica P. Simons, Sing Chau Ng, Shimul A. Shah, TheodoreP McDade, Giles F. Whalen, Jennifer F. Tseng

Identification of Quality Measures for Breast CancerSurgery and Assessment of Surgeon Variation at theUniversity of Vermont

Alicia R. Privette, Laurence McCahill, Ted James, SethHarlow, Mary Stanley, David Krag, Johanna Sheehey-Jones

Panel Discussion: When States Ensure Health CareCoverage: Lessons from Maine, Massachusetts andVermont

BREAK with POSTER SESSION

Factors Predicting Morbidity and Mortality in Emer-gency Colorectal Procedures in the Elderly

Edward A. McGillicuddy, Kevin M. Schuster, Kimberly A. Davis,Walter E. Longo

Merkel Cell Carcinoma: Evolution from Historical toCurrent Management Consensus

Bing Yi, Ponnandai Somasundar, James Koness, N. JosephEspat

Neoadjuvant Chemotherapy for Primary Breast Cancer:a Ten Year Institutional Experience

Hong Jun, John C. Russell, Charles Wiggins, Huining KangThe Impact of Body Mass Index on Outcomes in PartialNephrectomies for Renal Cell Cancer

Charles Dolce, William DeVoe, H. James Norton, DavidIannitti, B. Todd Heniford, Chris Teigland, Kent Kercher

The Relationship of Gender and Associated Outcomesof Traumatic Diaphragmatic Hernias

Charles Dolce, Jennifer Keller, K. Christian Walters, H. JamesNorton, David Iannitti, Kent Kercher, B. Todd Heniford

Quantitative Analysis of Gene Expression and Produc-tion of Multiple Growth Factors in the Early TendonHealing Stage: Implications in Molecular Therapy

Paul Liu, Jin Bo Tang, Chuan Hao ChenDevelopment of AAV2-VEGF for Gene Therapy- In VitroKinetics of Gene Expression

Paul Liu, Xiao Tian Wang, Qiang Zhong Ma, Anthony BaisUpper GI Multidisciplinary Cancer Program and Effi-ciency and Quality of Care

Laurence E. McCahill, Alicia Privette, Nicole Messier, JoanBlondin

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Can Aviation Based Team Training Contribute to Sus-tainable Personal Empowerment?

Harry C. Sax, Patrick Browne, Rebecca Burke, Nancy Coelho,Sandra Coletta, Kathleen Hittner

Immunohistological Characterization of Tissue Engi-neered Graft Remodeling in Severe CombinedImmunodeficienct/beige (SCID/bg) Mouse Model

Rajendra F. Sawh-Martinez, Narutoshi Hibino, Jason Roh,Tamar Mirensky, Christopher Breuer

Selective Anterior Sector Venous Outflow Reconstruc-tion After Live Donor Liver Transplantation (LDLT):Effect on Patient and Graft Survival

James J. Pomposelli, Kenneth McPartland, Khashayar Vakili,William D. Lewis, Roger L. Jenkins, Mohamed Akoad, Eliza-beth A. Pomfret

Parathyroid Devascularization: A Novel OperativeTechnique in Remedial Parathyroid Surgery

Tobias J. Carling, Patricia I. Donovan, Robert UdelsmanLaparoscopic Operative Skills are Predicted by VirtualReality Simulator Performance

Lucian Panait, Kurt E. Roberts, Robert L. Bell, MichaelMartinez, Stanley J. Dudrick, Andrew J. Duffy

Cumulative Initial Experience Using Hyaluronate-IodineComplex in Wound Healing

Robert A. Brenes, Michael S. Ajemian, Stanley J. DudrickEph-B4 Stimulates Endothelial Cell Migration by anAkt1-Dependent Mechanism

Tiffany T. Fancher, Akihito Muto, Tamara N. Fitzgerald, DaniaMagri, Stanley J. Dudrick, Alan A. Dardik

Feasibility and Development of Trigger Tools for Sur-veillance of Adverse Events in Ambulatory Surgery

Haytham M.A. Kaafarani, Amy K. Rosen, Jonathan Nebeker,Stephanie Shimada, Hillary Mull, Peter Rivard, Brenna Long,Lucy Savitz, Kamal M.F. Itani

Professionalism in Consult PracticesSusana C. Wishnia, Keren Ladin, Jack Ansell, James Petros,Jennifer Rosen

A Neoadjuvant Strategy for Pancreatic AdenocarcinomaHelps Patients Receive All Components of Care: Les-sons from a Single-institution Database

May Piperdi, Theodore P. McDade, Joon K. Shim, Mary E.Sullivan, Giles L. Whalen, Jennifer F. Tseng

Ergonomics of the Endocrine SurgeonMelanie Goldfarb, Sareh Parangi

Hyaluronic Acid/Carboxymethylcellulose (HA/CMC)Adhesion Barrier is Only Effective in Reducing Adhe-sion Formation at the Site of Placement in a Rat Model

Rizal Lim, Jonathan M Morrill, Ryan C. Lynch, Karen L. Reed,Adam C. Gower, Susan E. Leeman, Arthur F. Stucchi, JamesM. Becker

Sphingosine-1-phosphate Upregulates VascularEndothelial Growth Factor Expression in HumanNeuroblastoma Cells via S1P2/ROCK/ERK Pathway

Fernando Ferrer, Meihong Li, Teresa Sanchez, Tim HlaCatechin and Magnolol Ameliorate Oxidative Stress inPancreatic Acinar Cells

Julie A. Alosi, Debbie E. McDonald, David W. McFaddenMedical Student Performance in Surgical PatientSimulation Correlates With End-Of-Clerkship OralExamination Performance

Gladys L. Fernandez, Neal E. Seymour, David W Page

Early Graft Function in Pre-emptive Versus PreviouslyDialyzed Live Donor Kidney Transplant Recipients

Anthony Del Signore, Paul Morrissey, Staci Fischer, ReginaldGohh, Jason Machan, Anthony Monaco, Angelito Yango,Carolyn Young, Kevin P. Charpentier

Portal Venous Thrombi (PVT) Following Ileal Pouch-Anal Anastomosis (IPAA) for Ulcerative Colitis (UC): IsThere a Need for Early Post-Operative Detection?

Kelly D. Gonzales, Avneesh Gupta, Jaroslaw Tkacz, Arthur F.Stucchi, Jorge Soto, Erwin Hirsch, James M. Becker

Surgeons’ Volume of Colorectal Cancer Procedures andCollaborative Decision-making about Adjuvant Thera-pies

Selwyn O. Rogers, Jr., John Z. Ayanian, Clifford Y. Ko,Katherine L. Kahn, Alan M. Zaslavsky, Robert S. Sandler,Nancy L. Keating (Presented by Aundrea Oliver)

Do Learning Curves for Laparoscopic CholecystectomyExist in the Era of Laparoscopically-Trained SurgicalResidents?

Angela K. Moss, Bram A. Nijsse, Suzanne M. Sokal, David L.Berger

Total Extraperitoneal Inguinal Hernia Repair WithoutFixation: The Era of Minimal Pain and Negligible EarlyHernia Recurrence is Here

Evangelos Messaris, Guy Nicastri, Stanley J. DudrickSurgical Management of Two Consecutive PediatricParagangliomas with Aggressive Phenotypes

Christopher S. Muratore, Abigail Martin, Mimi S. Kim, Daniel S.Kim, Shamlal Mangray, Jose B. Quintos, Thomas F. Tracy

SCIENTIFIC SESSION IV

Trends in Presentation and Survival for GallbladderCancer Over More Than Four Decades. A Single Institu-tion Experience

Ioannis Konstantinidis, David Berger, Carlos Fernandez-delCastillo, Kenneth Tanabe, Cristina Ferrone

Results of Aggressive Surgical Resection for HilarCholangiocarcinoma

Mohamed Akoad, Kashayar Vakili, Kenneth McPartland,James J. Pomposelli, Elizabeth A. Pomfret, David W. Lewis,Roger L. Jenkins

Current Trends in Pancreatic Cystic Neoplasms: Watchand Wait, or Resect?

Cristina R. Ferrone, Camilo Correa-Gallego, Andrew L.Warshaw, William Brugge, David Forcione, Sarah P. Thayer,Carlos Fernandez-del-Castillo

Blunt Pancreato-Duodenal Injury: A Multi-Center Studyof the Research Consortium of New England Centersfor Trauma (ReCONECT)

George C. Velmahos, Malek Tabbara, Ronald Gross, PeterBurke, Timothy Emhoff, Rajan Gupta, Robert J. Winchell, LisaPatterson, Michael Rosenblatt, James Hurst, Bruce Crookes,Sheldon Brotman

Outcomes Following Severe Head Injury: An NTDBBased Comparison of Level I and Level II TraumaCenters

Fuad Alkhoury, John Courtney, Charles Bakhos, JudyO’Connor, Donald Kim, John Bonadies

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ETHICON ENDO-SURGERY SYMPOSIUMHighlighting Laparoscopic Liver Resection, Thyroidec-tomy and Bariatric Surgery.

PRESIDENT’S RECEPTION & BANQUET

Sunday, September 28, 2008

ANNUAL BUSINESS MEETING (Members Only)

1st Place Research Day PresentationsClinical Paper- Is Hepatitis C (HCV) Recurrence In-creased in the Recipients of Live Donor Right LobeLiver Grafts?

Jennifer E. VerbeseyBasic Paper - Improved Outcomes Following PeripheralNerve Repair Using a Photochemical Technique

Francis P. Henry, MD

SCIENTIFIC SESSION V

Novel Therapeutic Approaches to Premature LungDisease Utilizing Stem Cells

Christine Finck, Blair Roszell, Ariel Seaton, Guo-Hua FongDoes an Academic Incentive Plan Encourage Previ-ously Uncompensated Academic Pursuits in Surgery?

Chandrajit P. Raut, Christine C. Mitchell, Dennis P. Orgill,Michael J. Zinner, Stanley W. Ashley

BOOT CAMP: Implementation of an Intensive Simula-tion-based Educational Curriculum for New SurgicalInterns

Gladys L. Fernandez, Neal E. Seymour, Richard B. Wait,Patrick C. Lee, Loki Skylizard, Myron St. Louis, Ronald Bush,David W. Page

24TH ANNUAL SAMUEL JASON MIXTER LECTURELucian Leape, MD

PRESIDENTIAL ADDRESS Health, Society and the Surgeon: The News

Thomas A. Colacchio, MD

BOSTON & AREA ATTRACTIONS

SEAPORT DISTRICT ATTRACTIONS· Black Falcon Cruise Terminal· Boston Fire Museum· Boston Tea Party Ship & Museum· Castle Island· Children’s Museum· Harpoon Brewery· John Joseph Moakley US Courthouse· Spirit of Boston

MUSEUMS· Institute of Contemporary Art· Isabella Stewart Gardner Museum· JFK Library & Museum· Museum of Fine Arts, Boston· Museum of Science· New England Aquarium

SHOPPING· Charles Street in Beacon Hill· Copley Place· Newbury Street in Back Bay· Quincy Market· Shops at the Prudential

SIGHTSEEING TOURS· Boston Duck Tours· Old Town Trolley Tours

HISTORICAL ATTRACTIONS· Boston Common & Public Garden· Bunker Hill Monument· Faneuil Hall· Massachusetts State House· North End· Old North Church· Old State House· Paul Revere House· The Freedom Trail· Trinity Church· USS ConstitutionMARK YOUR CALENDAR

FUTURE NESS ANNUAL MEETINGS

September 11-13, 2009Hyatt Regency NewportNewport, Rhode Island

October 28-31, 2010The Saratoga Hilton

Saratoga Springs, New York

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FROM THE PRESIDENT (continued from page one)

Thank you for the honor of being theNew England Surgical Society Presi-dent-elect and I am looking forward toanother year of progress as we finish thereminder of 2008 and move into 2009.

During the last several months, Ihave had the privilege of working withothers in the NESS Leadership, onceagain, on numerous important initiativesas well as the selection of qualityscientific papers for presentation and

discussion during our upcoming Annual Meeting in Boston.Our Annual Meeting program is a very unique one and I amproud of our organization’s 89-year achievement in provid-ing a consistent quality educational forum that incorporatesan enjoyable social element as well.

In addition to the Annual Meeting, a key item on ourwork agenda for this year will be the aggressive develop-ment of our other important educational forum – the springNESS Resident and Fellow Research Presentation Day. Fora number of years now, this program has been developingat a steady pace with an ever increasing number of youngparticipants from academic programs throughout NewEngland. It is time we take this event to the next level withan application for CME accreditation as well as expandedmarketing efforts. Please remember that attendance of the

Research Day counts toward your NESS participationrequirement; plan to attend in 2009 and you will be im-pressed by our younger colleagues and their accomplish-ments.

Other items on the NESS agenda for the coming yearinclude the establishment of electronic membership ballot-ing, online membership dues renewal through the NESSwebsite, information exchange with the American College ofSurgeons and the American Board of Surgery through ourSociety representa-tives, and continuedefforts toward our 2016Centennial Celebrationproject.

Thank you againfor the privilege ofbeing the next NESSPresident. I lookforward to seeing youin Boston and feel freeto share your ideaswith me on how theNESS might enhanceits service to member-ship.

From the President-ElectFrancis D. Moore, Jr., MD

In keeping with the heat

of the political season

now upon us I have also

invited Susan Dentzer, a

former correspondent

for the Jim Lehrer News

Hour, to be our guest

speaker at the

President’s Dinner on

Saturday evening.

Thank you again for the

privilege of being the

next NESS President. I

look forward to seeing

you in Boston and feel

free to share your ideas

with me on how the

NESS might enhance its

service to membership.

Our long-term friend and colleague, Lucian Leape, willbe our 24th Annual Samuel Jason Mixter Lecturer. Inkeeping with the heat of the political season now upon us Ihave also invited Susan Dentzer, a former correspondentfor the Jim Lehrer News Hour, to be our guest speaker atthe President’s Dinner on Saturday evening.

Aside of the Annual Meeting, other actions undertakenby the Executive Committee this past year included workingin tandem with the Archives of Surgery in meeting newrequirements surrounding the publication of manuscriptsfrom our Annual Meeting. In addition, ground has beenbroken on projects related to the 100-year celebration of theNESS in 2016 which included the establishment of a newAd Hoc Centennial Celebration Committee. Another projectrelated to this has been working with the Countway Libraryin Boston on the categorization of the Society’s Archive intotheir “Finding Aid” online system; I encourage all NESSmembers to view what is now available from our expandingarchive by visiting this “Finding Aid” site at http://nrs.harvard.edu/urn-3:HMS.Count:med00102.

In conclusion, I willagain remind allmembers that thehealth and relevanceof our Society isdirectly related to yourinvolvement throughregular attendance atthe Annual Meeting;the educational impactfrom which becomesmore and morecomprehensive witheach passing year. I,therefore, look forwardto seeing you at thisyear’s meeting at theSeaport World TradeCenter and Hotel in Boston on September 26th to 28th.

Thomas A. Colacchio, M.D.

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Editor’s Corner (continued from page one)

Address entitled “Health, Society and the Surgeon: TheNews” on Sunday. In addition to the poster presentations,brief reports, and podium presentations there will be a paneldiscussion on three of our New England state’s ensuring ofhealth care coverage. For the first time our society will hosta dinner for new members and for members of the Ad HocIssues Committee. The society is trying to increase theinterest and participation of new members and this dinnershould serve as a wonderful start to the membership of ournew initiates. Dr. David Berger will demonstrate the secrethandshake at the dinner! I will be looking forward to seeingall of you in Boston. My camera and I will be on the lookoutfor candid shots of our members and guests.

We all know that summers are short in New England.In the northern locations of our region, our summer hasseen its share of wild weather. Tornadoes in New Hamp-shire and flooding in Maine and Vermont occurred. I playedgolf in New Hampshire in the beginning of August. Thisphoto tells it all about our rainy summer.

Earlier this month I was consulted on a young man withmild heart failure. He had a heart murmur even a first yearmedical student could appreciate. After multiple tests it wasdiscovered that he had a fistula between the sinus ofvalsalva of the aorta and the right ventricle. A few clicks on

the keyboard connected me to the Internet. A quick searchtold me that this was a rare condition that would requirehigh-risk cardiac surgery. We took the patient to theoperating room for corrective surgery. The picture belowwas taken in the operating room during that procedure.

One notices that there are three surgeons intensely focus-ing on the operation. Two are scrubbed and my partner anddivision chief, Dr. Frank Ittleman, is looking over the etherscreen giving advice and support. In this picture, you cansee the concentration of all involved. One important facetof surgery is the ability to call on your partners to help. Itmay not always involve their hands touching the patient, butgood partners are always there for support. Computers andthe Internet can provide information, but real surgical helpcomes from your partners. I am fortunate to have 3 excel-lent surgical partners including Dr. Mitch Norotsky who alsois a New England Surgery Society member. As I havewritten about in a previous newsletter, members of the NewEngland Surgical Society know that they can be called uponfor advice from other members.

I will be looking forward to seeing all of you in Boston.Let us hope that the Boston Red Sox will be closing in on aplayoff spot at the time of our meeting. The Evil Empire willbe in town playing our boys during our meeting.

Have a great fall.Bruce J. Leavitt, M.D.

Visit the New England SurgicalSociety’s Website for the latest

NESS News.

www.nesurgical.org

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From the NESS Representative to the American Board of SurgeryLenworth M. Jacobs, MD, MPH, FACS

Director UpdatesThe Board welcomed three new directors, selected by

their respective organizations, to begin six-year terms onthe Board: Bruce Schirmer, representing SAGES, AnthonySenagore, representing the American Board of Colon andRectal Surgery, and R. James Valentine, representing theAPDS. In addition, the American Board of Thoracic Surgeryhas selected Cameron Wright to begin a term on the Board,and he will attend the next meeting.

Directors completing their terms were Timothy Flynn,Chair of the Board, representing the APDS, JamesFleshman, representing the ABCRS, and Larry Kaiser,representing the ABTS. Dr. Jo Buyske, who representedSAGES to the Board, is now a member of the executivestaff of the ABS.

Staff ChangesAfter a national recruitment, Dr. Jo Buyske, previously

Chief of Surgery at Presbyterian Hospital and a Professor ofSurgery at the University of Pennsylvania, joined the staff ofthe ABS in January 2008 as Associate Executive Directorand Director of Evaluation, and assumed full responsibilityfor this position July 1, replacing Dr. Robert Rhodes. Dr.Rhodes will reduce his work to half-time and will be Associ-ate Executive Director for Vascular Surgery. In addition, hewill assist with several special research projects and withthe further development of the Maintenance of Certificationprogram.

Curriculum Project and SCOREThe Surgical Council on Resident Education, under the

direction of Dr. Dick Bell, and the General Surgery Resi-dents Committee (GSRC), under Dr. Stan Ashley, continuedto actively move forward with the further development ofmultiple aspects of the curriculum project. The scope of thediseases and operations to be included in the curriculumwas finalized in late 2007 and early 2008, and presently thegoals, objectives, and testing material for the first 117modules within this curriculum are under development withvolunteers from the GSRC and APDS.

Dr. Bell has secured contracts with B. C. DeckerPublishing, current publishers of ACS Surgery and theCameron Surgical Atlas, for full access to material in thosepublications, as well as with Lippincott and McGraw Hill forselective access to surgical educational material in theirpublications. In addition, SAGES, through President MarkTalamini, has generously offered their extensive library ofteaching videos and written material, focused on minimallyinvasive surgery and endoscopy, to the SCORE project.

Materials from all of these sources will be incorporatedinto a SCORE website, a beta version of which is due to goonline in September 2008, which will be used as sourcematerial for resident education, and will be presented withinthe context of the curriculum developed by the GSRC.

Construction of the website is being overseen by Mr.James Fiore, Director of Information Technology for theABS, and is subcontracted to Mr. Mark Hickey, an externalvendor. As noted, the initial debut of the website is sched-uled for September, at which time it will be made availableto a beta testing group of 33 surgical residencies whichhave been selected on a random basis to represent variouscharacteristics in regard to size, type, etc. The beta test isplanned for 8-10 months, with extensive feedback to besolicited during that time from users, and the final version ofthe website is projected to be available in July 2009, forrollout to all surgical residencies.

It is intended that the website will provide a “one-stop”location for varied and innovative educational material forsurgical residents, structured according to the surgicalcurriculum defined by the ABS. In addition, it will providequestions and other assessment methodologies designedto allow residents to self-assess their educational progressduring residency, and to compare themselves to nationalnorms.

More formalized educational and assessment tools areunder development on several fronts, and will be incorpo-rated into SCORE as they become available. For example,Dr. Gary Dunnington, Chair of Surgery at Southern IllinoisUniversity, and his staff, have developed an intraoperativeassessment tool focused on the objective evaluation ofmultiple operative procedures specific to various levels ofsurgical training. The ABS has recently agreed to under-write the testing and validation of this tool by Dr. Dunningtonover the next two years, with the intent of incorporating thisinto residency assessment when it has been fully proven.

Developmental costs of this project are being fundedprimarily by the ABS from institutional reserves; none of thecosts are incorporated into operating accounts and there-fore do not impact in any way on the costs of the examina-tions administered by the Board. In addition significantsupplementary funding for the first three years has beenprovided by the American College of Surgeons, the Ameri-can Surgical Association, and the Association of ProgramDirectors in Surgery, all of whom are members of theSCORE advisory panel.

Resident Educational RequirementsThe Board at its June meeting, after extensive discus-

sion, voted to initiate new requirements for surgical resi-dents in regard to the completion of structured formalcourses in three different areas: Advanced Cardiac LifeSupport (ACLS), Advanced Trauma Life Support (ATLS),and Fundamentals of Laparoscopic Surgery (FLS). Thefirst two of these courses have been widely incorporatedinto most surgical residencies at the present time, and thiswill formalize the requirement that a resident complete eachof these courses at least once during residency. FLS

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9

represents a new requirement, and is considered to be anexcellent way of rapidly gaining knowledge and experiencein the basics of laparoscopic surgery during the early yearsof residency. It has been developed over the last few yearsby SAGES, and wide experience has already been devel-oped with its use and value.

Completion of these courses will be a requirement forresidents finishing training in June of 2010.

Maintenance of CertificationThe other major project on which the ABS staff is

focusing is the further development of MOC, and in particu-lar the specifics of Part IV – assessment of performance inpractice. Most of the measures which have been publicizedby external groups relative to medical quality have focusedon processes of care. These are germane to primary andambulatory care, but have a less relevant role in assessingsurgical performance, where outcomes are more important.As a result, the ABS has been focusing on ways in whichsurgical outcomes can become more central to the assess-ment of MOC Part IV, and is actively working with theAmerican College of Surgeons in the development of itsCase Logging System and Web Portal for Fellows. Dr.

John Birkmeyer and Dr. Clifford Ko are working with Dr.Barbara Bass and the NSQIP Committee of the ACS, toevaluate new and innovative ways of logging surgicalprocedure outcomes which may be used in satisfying therequirements of Part IV. In addition, Dr. Frank Opelka andthe Surgical Quality Alliance (SQA), with representationfrom the ACS and most of the surgical specialty societies, isactively exploring the development of a registry which wouldsatisfy most of the outcome measures needed to definesurgical quality, as well as other information relative tosurgical performance. The Board is actively participating inall of these efforts and anticipates that the requirements ofPart IV will continuously evolve in the next few years asimproved measures become available.

Orientation Video for Certifying Examination CandidatesIt has become obvious in the last few years that the oral

examination for general surgery certification has become anobject of irrational proportions in the eyes of many graduat-ing surgical residents, and multiple myths, word-of-mouthspeculation, and misinformation are propagated in regard toit. One of the consequences is that it is widely believed bysurgical residents that “prep” courses are necessary to

prepare for the examination, and wellover half of all candidates taking theexamination now subscribe to suchcourses, which may well cost upwardsof $2500 and consume three or fourdays, despite the lack of evidence thatsuch courses have any benefit. Inreality, the CE focuses entirely on basicgeneral surgical knowledge, does nottest on esoterica, and is intended only toassess the basic competency and safetyof a graduating resident.

To provide better preparatoryinformation to examination candidatesand help dispel some of the rumors, theBoard is developing an informationalorientation video which will be mailed toall candidates who are taking theexamination for their use. This will befilmed later this fall, and will be scripted,narrated, and produced by Dr. JackPickleman and his wife Brenda, with theintent of being ready for the graduates inJune 2009.

NecrologyWe were saddened to learn of the

deaths of the following Senior Members:Jesse E. Thompson, February 25, 2008,and James C. Thompson, May 9, 2008,and Michael E. DeBakey, July 11, 2008.

AMERICAN BOARD OF SURGERY

SUMMARY OF 2007-2008 EXAMINATIONS

Examination

# of Examinees

# Pass

# Fail

Pass Rate

Fail Rate

Total # Diplomates

Qualifying

1293

1,010

283

78.1%

21.9%

Recertification

1703

1,601

102

94.0%

6.0%

17,533

Vascular Surgery QE

106

95

11

89.6%

10.4%

Vascular Surgery Recert.

174

163

11

93.7%

6.3%

1,612

Surgical Critical Care

128

116

12

90.6%

9.4%

2,473

SCC Recertification

101

89

12

88.1%

11.9%

1,146

Pediatric Surgery QE

64

61

3

95.4%

4.6%

Pediatric Surgery Recert.

122

116

6

95.1%

4.9%

660

Hand Surgery

6

3

3

50.0%

50.0%

237

Hand Surgery Recert.

13

13

0

100%

0%

141

Vascular Surgery ITE

240

---

---

N.A.

N.A.

Pediatric Surgery ITE

85

---

---

N.A.

N.A.

ITE – Junior Level Exam

3913

---

---

N.A.

N.A.

ITE – Senior Level Exam

3699

---

---

N.A.

N.A.

Certifying

1290

1,034

256

80.0%

20.0%

54,802

Pediatric Surgery CE

70

64

6

91.4%

8.6%

1,059

Vascular Surgery CE

114

107

7

93.9%

6.1%

2,783

TOTAL

13,121

N.A. = Not applicable. 5,184 examinees, excluding the ITE, VSITE and PITE.

10

From the NESS Representative to the ACS Advisory Council for General SurgeryKristen A. Zarfos, MD

The Advisory Council for General Surgery to theAmerican College of Surgeons met April 5, 2008, in Chi-cago, Illinois.

The Council is comprised of a representative from eachof the eight U.S. regional surgical Societies, one each fromthe American Surgical Association, the American Society ofGeneral Surgeons, the Canadian Association of GeneralSurgeons, the American Board of Surgery, the ACS Boardof Regents, the ACS Candidate and Associate Society, theYoung (under 45 yo) Surgeons Committee, five Members-at-Large, two ACS Staff Liasions. The chairman is Dr.David Feliciano.

Reports to the Council included:Groundbreaking for a new American College of Sur-geons building in Washington, D.C., to house theWashington ACS staff and several surgical societieswas scheduled for May, 2008.The Surgeons Diversified Investment Fund (SDIF), inwhich the College has investments, is now available toindividuals and surgical organizations.Meetings have been set for the Society of ThoracicSurgery and Society of Vascular Surgery to discusspotential collaboration in data collection and feedbackusing the National Surgical Quality ImprovementProgram (NSQUIP).The ACSPA-Surgeons PAC wasreported as doing well, with contribu-tions made to Congressional leadersand other members of Congresswho have supported the College’slegislative agenda. ACS has contin-ued meetings regarding Medicarepayment reform.

Definition of General SurgeryA significant portion of the meeting

was devoted to the creation of thedefinition of general surgery. Dr.Feliciano presented his draft “Descriptionof a General Surgeon” and a lengthydiscussion ensued, emphasizing theissue of the rapidly evolving field of whatgeneral surgery encompasses. Sugges-tions were discussed and collected. Dr.Feliciano was to present a final revision to the June 2008Board of Regents meeting for approval.

Development of an Organization within the AmericanCollege of Surgeons Devoted to General Surgery

June 2007 the Advisory Council for General Surgeryproposed the establishment of an Academy of GeneralSurgery within the American College of Surgeons to theBoard of Regents. The Regents tabled the proposal. Agreat deal of time was spent at the April 5 meeting discuss-ing this issue, with the consensus being that the concept ofan “academy” be modified to reflect an Office for GeneralSurgery . The initial directorship would be lead by a pastACGS chairman. Dr. Feliciano was to circulate a revisedproposal with details of structure, governance, funding, andwhat role it would serve the ACS membership to the Advi-sory Council for approval and then to the Board of Regents.

Rural SurgeryAttention to the general surgical needs in rural America

remains a priorty of the Advisory Council. Issues of theseneeds and how to address them were discussed. The fifthannual Rural Surgery Meeting will be held during the 2008Clinical Congress. ACS members are encouraged to attend.

Clinical CongressThe Clinical Congress was studied and reviewed at a

Strategic Planning Retreat by the ACS Program Committee.Action items approved by the Board ofRegents included: (1) the implementa-tion of discipline-based and thematictracts, designating all sessions asplenary sessions, (2) expansion of thereview process for the Papers andPosters portion to involve members ofthe standing committees and AdvisoryCouncil engaged in the development ofthe tracks, (3) charging a late registra-tion fee after a cut-off date, and (4) theexpansion of the Clinical Congressvenues to include Boston and SanDiego.

The 2008 Clinical Congress post-graduate courses and 2009 AdvisoryCouncil proposed courses were dis-cussed. ACS members are invited tosubmit suggestions for presentationsand panels. The 2010 Clinical Congress

will be moved to Washington, D.C. from the previous site ofNew Orleans.

Attention to the general

surgical needs in rural

America remains a

priorty of the Advisory

Council. Issues of these

needs and how to ad-

dress them were dis-

cussed. The fifth annual

Rural Surgery Meeting

will be held during the

2008 Clinical Congress.

11

2008 NESS Resident Research Day Winners

The New England Surgical Society’s 15th Annual Surgical Resident and Fellow Research Presentation Day was heldon Friday, May 16, 2008 at The Conference Center at Harvard Medical School in Boston, Massachusetts.

BASIC SCIENCE

1st Place Francis P. Henry, MD

Massachusetts General Hospital

“Improved Outcomes Following Peripheral Nerve

Repair Using a Photochemical Technique”

Runner-Up Alan A. Thomay, MD

Rhode Island Hospital

“The Lack of IL-1 Signaling Decreases Fibrosis in

Sterile Wounds With No Effect on Tensile

Strength”

CLINICAL SCIENCE

1st Place Jennifer E. Verbesey, MD

Lahey Clinic

“Is Hepatitis C (HCV) Recurrence Increased in the

Recipients of Live Donor Right Lobe Liver Grafts?”

Runner-Up Heather Lynn Yeo, MD

Yale University

School of Medicine

“Tomorrow’s Surgeons: Expectations of the US

General Surgery Categorical Intern Class of 2007”

From the NESS Representative to the ACS Board of GovernorsCharles M. Ferguson, MD

The Board of Governors met October 7, 2007, inconjunction with the annual Clinical Congress. The Gover-nors have identified Reimbursement, Liability, and WorkForce Issues as major areas of concern. The ACS contin-ues to work diligently through the Washington office toaddress Medicare physician reimbursement cuts. AllFellows are encouraged to notify their senators’ officesimmediately to express concern over pending legislationwhich would further reduce physician reimbursement.Though numerous governors expressed cynicism as to theability of Pay for Performance to have any true positiveimpact on patient care, it seems clear that this movementwill continue to expand, and the ACS offers support viaNISQIP and the Web Portal. Liability issues remain a majorproblem for multiple areas of the country. Tort reform at thefederal level is felt to be dead, and though several stateshave initiated significant tort reform, others have suchhostile environments that surgeon recruitment and retentionis a problem. This further impacts all health care access, ason average General Surgery produces 40% of hospitals’margins, and the lack of availability of general surgeonseffects the ability of hospitals to remain open. Work ForceIssues are felt to be a major concern because of a pro-jected deficit in surgeon availability by 2020. While severalmedical schools have expanded their class size and severalnew medical schools have opened, this will not increasesurgeon availability as their has been no increase in surgi-cal residency positions in over 20 years, and without a newsource for funding, it will not be possible to increase thenumber of such positions. The College is to embark on a

major study on workforce in collaboration with HarvardSchool of Public Health.

On a positive note, the College is in a good financialsituation, with total assets of $473,687,000. There iscurrently $387,115,000 in investment assets, with 16.3%annual return. Overhead runs a respectable 28%. Fellowsare reminded that the Surgeons Diversified InvestmentFund is managed by the same investment firm as theCollege’s investments, with similar returns, and is open toall Fellows.

The Board of Regents has identified a communicationproblem with the Board of Governors. This was quiteevident at the Oct.7 meeting of the Board of Governors,when it was pointed out by a member of the Governors thatall of the Regents had actually left the meeting (for ameeting of the Board of Regents) during the discussionperiod of the Board of Governors meeting. The Regentshave subsequently had two “webinar” meetings open to allmembers of the Board of Governors to discuss issues andget direct feedback. These meetings have been quiteinformative for both groups, have been well “attended”(meetings are held on the internet, so attendance is “vir-tual”), and have been viewed quite positively by all .

Finally, the College has been quite active in legislativeissues this year. All Fellows have received communicationfrom the college regarding the proposed Medicare cuts andhave been urged to contact their legislators in regards totheir voting. These initiatives will certainly continue in thecoming year, when health care reform is sure to be apolitical issue with the new administration.

FIRST CLASS

U.S. Postage

PAID

Plymouth, MA

Permit No. 55

New England Surgical Society900 Cummings Center, Suite 221-UBeverly, MA 01915

2008 Annual Meeting Preliminary Program

Message from the President

Message from the President-Elect

Reports from the NESS Representatives to theACS Board of Governors, Advisory Councilfor General Surgery, and the American Board ofSurgery

INSIDE THIS ISSUE....

About The NESS Charitable Foundation

The NESS Charitable Foundation was established in the early 1980sand exists to provide financial support for the betterment of surgery inNew England, through the education offered at the NESS Annual Meet-ings, as well as the professional development of young surgeons throughthe NESS Resident and Fellow Research Presentation Day.

Specific contributions currently made by the NESS Charitable Foundationon an annual basis include:

Support of the Spring Resident and Fellow Research PresentationDay.Sponsorship of the Annual Meeting’s Samuel Jason Mixter Lecturer.Sponsorship of the Nathan Smith Award at the Annual Meeting.Sponsorship of the New Member, Resident, and Poster Prizesawarded at the Annual Meeting.

In addition to the above, the Foundation is regularly called upon tohelp support other educational initiatives approved by the NESS Execu-tive Committee that would benefit the surgical specialty.

The NESS Executive Committee encourages NESS members to make annual donations to this important re-source. Please note that contributions can also be made through the purchase of the official necktie, bowtie, or scarf of theorganization as a portion of those proceeds are automatically transferred to the Foundation.